Charles A. Enke, MD

Radiation therapy has an essential role for certain patients with DLBCL. It is hoped that ongoing and future trials will identify the patients who will benefit from this treatment and those for whom it is unnecessary.

The article entitled “Diagnosis and Management of Mycosis Fungoides” by Shira Galper, Benjamin Smith, and Lynn Wilson is an excellent contemporary summary of the workup and management of mycosis fungoides (MF) and its leukemia variant, Sézary syndrome (SS). In their discussion of the diagnosis and staging of MF and SS, the authors include a discussion of proposed revisions by the International Society for Cutaneous Lymphoma and the European Organisation for the Research and Treatment of Cancer (ISCL/EORTC) which seek to identify prognostic subgroups. In addition, there is a complete overview of the various treatment options for management of MF and SS. This treatment overview closely parallels the 2010 National Comprehensive Cancer Network (NCCN) Practice Guidelines for MF and SS.

The most common indolent lymphoma, follicular lymphoma comprises
35% of adult non-Hodgkin’s lymphoma (NHL) in the United
States and 22% worldwide. Features associated with adverse outcome
include age, male gender, disease stage, and performance status, with
the International Prognostic Index being the most widely used risk classification
system. Long-term disease-free survival is possible in select
patient subgroups after treatment, but very late relapses suggest that
quiescent lymphoma cells might be harbored for long periods of time.
Radiation therapy is the mainstay of treatment for limited-stage follicular
lymphoma, but there is some experience with chemotherapy and
combined chemoradiation. When to initiate treatment in patients with
advanced disease is controversial, but options include various combined
chemotherapy regimens, monoclonal antibodies, radiolabeled antibodies,
and bone marrow or stem cell transplantation. Future directions in
the treatment of follicular lymphoma include vaccines, antisense
therapy, and proteasome inhibitors.

Together, parts 1 and 2 of the
article by Drs. Wilson and
Smith on the “Management of
Mycosis Fungoides” serve as an excellent
reference for the diagnosis and
management of this subtype of cutaneous
T-cell lymphoma. Part 1, which
deals with the diagnosis, staging, and
prognosis of mycosis fungoides, appeared
in the September 2003 issue of
this journal. Part 2, which deals with
treatment, appears in the current issue.
The article is a concise overview
of the numerous treatment strategies
and specific treatments available for
various stages and presentations of
mycosis fungoides.

Together, parts 1 and 2 of the
article by Drs. Wilson and
Smith on the “Management of
Mycosis Fungoides” serve as an excellent
reference for the diagnosis and
management of this subtype of cutaneous
T-cell lymphoma. Part 1, which
deals with the diagnosis, staging, and
prognosis of mycosis fungoides, appeared
in the September 2003 issue of
this journal. Part 2, which deals with
treatment, appears in the current issue.
The article is a concise overview
of the numerous treatment strategies
and specific treatments available for
various stages and presentations of
mycosis fungoides.

Although bone pain from osteoblastic metastases can be ameliorated 50% to 80% of the time by use of intravenously or orally administered radiopharmaceuticals, we cannot accurately predict who will or will not